Frequency and findings of the acquired anorectal disease in the pediatric population with chronic constipation.

Sanchez-Avila MT, Garcia-Valencia OA, Rivas-Calderon M, Morales-Garza LA, Jacobo-Velazquez P, Chavez-Caraza KL. Frequency and findings of the acquired anorectal disease in the pediatric population with chronic constipation. Turk J Pediatr 2018; 60: 547-553. To determine the frequency of anorectal disease associated with chronic constipation in children we conducted an observational, descriptive, retrospective study. One hundred and sixty eight patients were evaluated by anorectal manometry over a 10-year period. The population was divided into organic constipation (OC) and functional constipation (FC) per ROME III criteria. Of those: 95 (56.54%) presented with anorectal disease. The age range was 1-17 (mean 5.3). Eighteen presented with OC and 77 with FC. Acute anal fissure was found in 45 patients (38 FC, 7 OC), chronic anal fissure in 38 (30 FC, 8 OC), perianal erythema in 26 (23 FC, 3 OC), scar tissue was found in 28 (24 FC, 4 OC), anal mucosa congestion in 27 (22 FC, 5 OC), hemorrhoidal disease in 26 (20 FC, 6 OC) and perianal venous dilatation in 21 (16 FC, 5 OC). Anal fissure, perianal erythema, and venous dilation occurred more frequently in patients with an anterior ectopic anus. An anal fissure was present in more than 80% of patients who had puborectalis muscle and external anal sphincter dysfunction. We concluded that the frequency of acquired anorectal disease in children with chronic constipation is high; early diagnosis and treatment are priorities for the successful management of these patients.